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General NPI Number Information
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NPI Number | 1417218090
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Entity Type | Organization
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Legal Business Name | ADVANCED NEUROLOGICAL DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 2639 CURRY LN
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City | NOKOMIS
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State | FL
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Zip | 34275-4903
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Country | US
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Telephone | 61-779-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 2639 CURRY LN
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City | NOKOMIS
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State | FL
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Zip | 34275-4903
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Country | US
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Telephone | 617-797-0110
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Fax | 941-894-1176
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | PATRICK JOSEPH MADDEN
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Credential |
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Telephone | 617-797-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME113116
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License Number State | FL
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